Provider Demographics
NPI:1427267533
Name:CWCC INC
Entity type:Organization
Organization Name:CWCC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:CONNOLLY-WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:860-651-3954
Mailing Address - Street 1:530 BUSHY HILL RD
Mailing Address - Street 2:
Mailing Address - City:SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06070-2995
Mailing Address - Country:US
Mailing Address - Phone:860-651-3954
Mailing Address - Fax:
Practice Address - Street 1:530 BUSHY HILL RD
Practice Address - Street 2:
Practice Address - City:SIMSBURY
Practice Address - State:CT
Practice Address - Zip Code:06070-2995
Practice Address - Country:US
Practice Address - Phone:860-651-3954
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001674111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty